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Analysis of Postoperative Knee Dysfunction Following a Distal Femur Fracture Managed by Different Surgical Methods
Swapnali D Jadhav1, Sandeep Shinde1, Siddhi P Patrekar1
1Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.
Cureus
|July 1, 2026
Summary
Intramedullary nailing (IMN) offers better functional outcomes and fewer complications for distal femur fractures compared to open reduction-internal fixation (ORIF). Postoperative knee dysfunction is common with both methods, emphasizing early mobilization.
Area of Science:
- Orthopedics
- Trauma Surgery
- Biomechanics
Background:
- Distal femur fractures significantly impact knee biomechanics and function.
- These fractures commonly affect older females (low-energy falls) and younger males (high-energy injuries).
- Surgical management often involves open reduction-internal fixation (ORIF) or intramedullary nailing (IMN).
Purpose of the Study:
- To analyze postoperative knee dysfunction and functional outcomes after distal femur fracture repair.
- To compare outcomes between ORIF and IMN surgical approaches.
- To evaluate range of motion, muscle strength, and functional recovery.
Main Methods:
- Cross-sectional study involving 108 patients (54 ORIF, 54 IMN) with distal femur fractures.
- Data collected included demographics, injury details, surgical approach, range of motion, muscle strength, limb length, and girth.
- Assessed complications (stiffness, shortening, extensor lag) and functional outcomes using Schatzker and Lambert criteria.
Main Results:
- Knee stiffness was the most frequent postoperative complication, followed by quadriceps wasting and gait deviations.
- Extensor lag and limb shortening were observed in a significant number of patients.
- The IMN group demonstrated a significantly higher rate of excellent functional results and fewer complications (infection, stiffness) compared to ORIF.
Conclusions:
- Postoperative knee dysfunction is prevalent after distal femur fracture surgery, irrespective of fixation method.
- Early mobilization and appropriate fixation techniques are critical for optimal patient recovery.
- IMN is associated with superior functional outcomes and a lower complication rate than ORIF for supracondylar femur fractures.